tbuckley/cabot-search huggingface dataset:
The <i>BJD</i>’s approach to global health and equity in publishing: adding author reflexivity statements
Authors: Esther E Freeman, Valeska Padovese, Archana Singal, Rie Yotsu, Linda Oyesiku, Alaina J James, Francisco G Bravo, Anisa Mosam
Journal: British Journal of Dermatology (2023)

The editors of the BJD’s Global Health and Equity section describe updated submission guidelines for their section, highlighting the role of structured author reflexivity statements in improving equitable publishing practices in the dermatological literature.
Humoral and cellular immunity to SARS-CoV-2 Ancestral and Omicron BA.5 variants following vaccination in myelofibrosis patients
Authors: Ahmad Alcheikh, Griffith B. Perkins, Phillippa A. Pucar, Amelia Cecchin, Cheng Sheng Chai, Matthew Tunbridge, Anouschka Akerman, Anupriya Aggarwal, Vanessa Milogiannakis, Stuart Turville, Sharon Allen, Pravin Hissaria, Tatjana Banovic, P. Toby Coates, David M. Ross
Journal: Blood Cancer Journal (2023)
Age of onset defines two distinct profiles of atopic dermatitis in adults
Authors: Paola Facheris, Joel Correa Da Rosa, Angel D. Pagan, Michael Angelov, Ester Del Duca, Grace Rabinowitz, Pedro Jesús Gómez‐Arias, Camille Rothenberg‐Lausell, Yeriel D. Estrada, Swaroop Bose, Mashkura Chowdhury, Avner Shemer, Ana B. Pavel, Emma Guttman‐Yassky
Journal: Allergy (2023)

Abstract Background The incidence of adult‐onset atopic dermatitis (AOAD) is increasing. However, the unique characteristics of AOAD compared to pediatric‐onset AD persisting into adulthood (POAD) are underexplored, hampering the development of targeted‐therapeutics for this growing population. We thus assessed the profile of AOAD in skin and blood compared to that of POAD. Methods We collected skin biopsies and blood from adults with AOAD, POAD, and healthy controls ( n = 15 in each group). Skin samples were analyzed by RNA sequencing, qRT‐PCR, and immunohistochemistry, and Olink Proseek multiplex assay was used to identify the serum proteomic profile. Results Compared to healthy controls, both AOAD and POAD showed cutaneous immune and barrier dysregulations with a shared Th2/Th22 hyperactivation. Overall, POAD showed greater inflammation in lesional skin, with more prominent expression of Th2/Th17/Th22 markers (CCL17/22, S100A8/9, IL‐36A, PI3/Elafin, DEFB4) in POAD compared to AOAD ( p ‐value &lt; .05). In contrast, higher Th1‐(IFN‐γ, IL‐2, IL‐15, CCL5) upregulation and Th1‐skewing were seen in AOAD. The epidermal barrier was also more compromised in POAD, with greater epidermal hyperplasia and lower expression of markers related to terminal differentiation, lipids, and cell adhesion. In parallel with increased rates of cardiovascular comorbidities, AOAD demonstrated many more significantly dysregulated proteins in serum ( n = 148) compared to POAD ( n = 86), including pro‐inflammatory and cardiovascular‐risk markers. Th1‐related products showed significant correlations between their skin and blood expressions only in AOAD subjects. Conclusion Age‐of‐onset delineates two distinct endophenotypes in adult AD potentially suggesting the need for broader (beyond Th2) therapeutic targeting in AOAD.
Super-enhancer-driven TOX2 mediates oncogenesis in Natural Killer/T Cell Lymphoma
Authors: Jianbiao Zhou, Sabrina Hui-Min Toh, Tze King Tan, Kalpnaa Balan, Jing Quan Lim, Tuan Zea Tan, Sinan Xiong, Yunlu Jia, Siok-Bian Ng, Yanfen Peng, Anand D. Jeyasekharan, Shuangyi Fan, Soon Thye Lim, Chin-Ann Johnny Ong, Choon Kiat Ong, Takaomi Sanda, Wee-Joo Chng
Journal: Molecular Cancer (2023)

Abstract Background Extranodal natural killer/T-cell lymphoma (NKTL) is an aggressive type of non-Hodgkin lymphoma with dismal outcome. A better understanding of disease biology and key oncogenic process is necessary for the development of targeted therapy. Super-enhancers (SEs) have been shown to drive pivotal oncogenes in various malignancies. However, the landscape of SEs and SE-associated oncogenes remain elusive in NKTL. Methods We used Nano-ChIP-seq of the active enhancer marker histone H3 lysine 27 acetylation (H3K27ac) to profile unique SEs NKTL primary tumor samples. Integrative analysis of RNA-seq and survival data further pinned down high value, novel SE oncogenes. We utilized shRNA knockdown, CRISPR-dCas9, luciferase reporter assay, ChIP-PCR to investigate the regulation of transcription factor (TF) on SE oncogenes. Multi-color immunofluorescence (mIF) staining was performed on an independent cohort of clinical samples. Various function experiments were performed to evaluate the effects of TOX2 on the malignancy of NKTL in vitro and in vivo. Results SE landscape was substantially different in NKTL samples in comparison with normal tonsils. Several SEs at key transcriptional factor (TF) genes, including TOX2, TBX21(T-bet), EOMES, RUNX2, and ID2 , were identified. We confirmed that TOX2 was aberrantly overexpressed in NKTL relative to normal NK cells and high expression of TOX2 was associated with worse survival. Modulation of TOX2 expression by shRNA, CRISPR-dCas9 interference of SE function impacted on cell proliferation, survival and colony formation ability of NKTL cells. Mechanistically, we found that RUNX3 regulates TOX2 transcription by binding to the active elements of its SE. Silencing TOX2 also impaired tumor formation of NKTL cells in vivo. Metastasis-associated phosphatase PRL-3 has been identified and validated as a key downstream effector of TOX2-mediated oncogenesis. Conclusions Our integrative SE profiling strategy revealed the landscape of SEs, novel targets and insights into molecular pathogenesis of NKTL. The RUNX3-TOX2-SE-TOX2-PRL-3 regulatory pathway may represent a hallmark of NKTL biology. Targeting TOX2 could be a valuable therapeutic intervene for NKTL patients and warrants further study in clinic.
Observation and treatment in DDX41-mutated acute myeloid leukemia and myelodysplastic syndrome
Authors: Aref Al-Kali, Ahmad Nanaa, David Viswanatha, Rong He, Phuong Nguyen, Dragan Jevremovic, James M. Foran, Cecelia Arana Yi, Patricia T. Greipp, Naseema Gangat, Mrinal Patnaik, Ayalew Tefferi, Mark R. Litzow, Abhishek A. Mangaonkar, Mithun Vinod Shah, Talha Badar, Hassan B. Alkhateeb
Journal: Blood Cancer Journal (2023)
Neutrophil extracellular traps formed during chemotherapy confer treatment resistance via TGF-β activation
Authors: Alexandra Mousset, Enora Lecorgne, Isabelle Bourget, Pascal Lopez, Kitti Jenovai, Julien Cherfils-Vicini, Chloé Dominici, Géraldine Rios, Cédric Girard-Riboulleau, Bodu Liu, David L. Spector, Sidse Ehmsen, Shufang Renault, Caroline Hego, Fatima Mechta-Grigoriou, François-Clément Bidard, Mikkel Green Terp, Mikala Egeblad, Cédric Gaggioli, Jean Albrengues
Journal: Cancer Cell (2023)
Effect of a Coaching Intervention to Improve Cardiologist Communication
Authors: Kathryn I. Pollak, Maren K. Olsen, Hongqiu Yang, Neil Prose, Larry R. Jackson, Sandro O. Pinheiro, T. Kayla Dunbar, Kimberly S. Johnson
Journal: JAMA Internal Medicine (2023)

Communication between cardiologists and patients can significantly affect patient comprehension, adherence, and satisfaction. To our knowledge, a coaching intervention to improve cardiologist communication has not been tested.
Association Between Early Prostacyclin Therapy and Extracorporeal Life Support Use in Patients With Congenital Diaphragmatic Hernia
Authors: Akila B. Ramaraj, Samuel E. Rice-Townsend, Carrie L. Foster, Delphine Yung, Emma O. Jackson, Ashley H. Ebanks, Matthew T. Harting, Rebecca A. Stark, Kevin Lally, Pam Lally, Yvette Boyd
Journal: JAMA Pediatrics (2023)

Prostacyclin (PGI2) is a therapeutic option to treat congenital diaphragmatic hernia (CDH)-associated pulmonary hypertension in neonates. Its use may decrease the need for extracorporeal life support (ECLS).
Efficacy and Safety of Avalglucosidase Alfa in Patients With Late-Onset Pompe Disease After 97 Weeks
Authors: Priya S. Kishnani, Jordi Diaz-Manera, Antonio Toscano, Paula R. Clemens, Shafeeq Ladha, Kenneth I. Berger, Hani Kushlaf, Volker Straub, Gerson Carvalho, Tahseen Mozaffar, Mark Roberts, Shahram Attarian, Yin-Hsiu Chien, Young-Chul Choi, John W. Day, Sevim Erdem-Ozdamar, Sergey Illarioshkin, Ozlem Goker-Alpan, Anna Kostera-Pruszczyk, Ans T. van der Ploeg, Kristina An Haack, Olivier Huynh-Ba, Swathi Tammireddy, Nathan Thibault, Tianyue Zhou, Mazen M. Dimachkie, Benedikt Schoser, Anthony Behin, Matthias Boentert, Gerson Carvalho, Nizar Chahin, Joel Charrow, Patrick Deegan, Hacer Durmus Tekce, Fanny Duval, Angela Genge, Ludwig Gutmann, Robert D. Henderson, Julia B. Hennermann, Tarekegn Hiwot, Derralynn Hughes, Amel Karaa, Chafic Karam, Alexandra Kautzky-Willer, Hirofumi Komaki, Pascal Laforet, Nicola Longo, Vera Malinova, Ricardo Maré, Clarisa Maxit, Eugen Mengel, Maurizio Gualtiero Moggio, Mária Judit Molnár, Tiziana Enrica Mongini, Aleksandra Nadaj-Pakleza, Andres Nascimento Osorio, Jean-Baptiste Noury, Acary Souza Bulle Oliveira, Yesim Parman, Loren Pena, Gauthier Remiche, Monica Sciacco, Perry B. Shieh Shieh, Cheryl Smith, Thomas Stulnig, Frederic Taithe, Céline Tard, Mark Tarnopolsky, Matthias Vorgerd, Chester Whitley, Peter Young, Jorge Alonso-Pérez, Patricia Altemus, Anne-Catherine Aubé-Nathier, Jennifer B.  Avelar, Carrie Bailey, Can Ebru Bekircan-Kurt, Jenny Billy, Silvia Boschi, Kathryn E. Brown, Laura Carrera Garcia, Lauren Chase, Hamilton Cirne, Loïc Danjoux, Jean-Baptiste Davion, Stephanie DeArmey, Ekaterina Fedotova, Eve Gandolfo, Zoltan Grosz, Dewi Guellec, Anne-Katrin Guettsches, Michela Guglieri, Erin Hatcher, Sina Helms, Miriam Hufgard-Leitner, Sergey A. Klyushnikov, Jacqui Langton, Lenka Linková, Nicolas Mavroudakis, Stella Mazurová, Madoka Mori, Louisa Müller-Miny, Olimpia Musumeci, Christopher S. Nance, Daniel Natera-de Benito, Robert Neel, Gabriela A. Niizawa, Lauren Noll, Erik Ortega, Mamatha Pasnoor, Vivien Pautot, Anna Potulska-Chromik, Alessia Pugliese, Claire Questienne, Margarida Ramos Lopes, David Reyes-Leiva, Michaela Riedl, Marcelo Francisco Rugiero, Emmanuelle Salort-Campana, Paulo Victor Sgobbi Souza, Guilhem Sole, Luca Solera, Suzara Souto Lopes, Sabine Specht, Jeffrey Statland, Andrea Swenson, Chong Yew Tan, Sónia Tizon, N.A.M.E. van der Beek, Harmke A. van Kooten, Marie Wencel, Stephan Wenninger, Fabien Zagnoli
Journal: JAMA Neurology (2023)

In the previously reported Comparative Enzyme Replacement Trial With neoGAA Versus rhGAA (COMET) trial, avalglucosidase alfa treatment for 49 weeks showed clinically meaningful improvements in upright forced vital capacity (FVC) percent predicted and 6-minute walk test (6MWT) compared with alglucosidase alfa.
FOXK1 regulates Wnt signalling to promote cardiogenesis
Authors: Javier E Sierra-Pagan, Nikita Dsouza, Satyabrata Das, Thijs A Larson, Jacob R Sorensen, Xiao Ma, Patricia Stan, Erik J Wanberg, Xiaozhong Shi, Mary G Garry, Wuming Gong, Daniel J Garry
Journal: Cardiovascular Research (2023)

Abstract Aims Congenital heart disease (CHD) is the most common genetic birth defect, which has considerable morbidity and mortality. We focused on deciphering key regulators that govern cardiac progenitors and cardiogenesis. FOXK1 is a forkhead/winged helix transcription factor known to regulate cell cycle kinetics and is restricted to mesodermal progenitors, somites, and heart. In the present study, we define an essential role for FOXK1 during cardiovascular development. Methods and results We used the mouse embryoid body system to differentiate control and Foxk1 KO embryonic stem cells into mesodermal, cardiac progenitor cells and mature cardiac cells. Using flow cytometry, immunohistochemistry, cardiac beating, transcriptional and chromatin immunoprecipitation quantitative polymerase chain reaction assays, bulk RNA sequencing (RNAseq) and assay for transposase-accessible chromatin using sequencing (ATACseq) analyses, FOXK1 was observed to be an important regulator of cardiogenesis. Flow cytometry analyses revealed perturbed cardiogenesis in Foxk1 KO embryoid bodies (EBs). Bulk RNAseq analysis at two developmental stages showed a significant reduction of the cardiac molecular program in Foxk1 KO EBs compared to the control EBs. ATACseq analysis during EB differentiation demonstrated that the chromatin landscape nearby known important regulators of cardiogenesis was significantly relaxed in control EBs compared to Foxk1 KO EBs. Furthermore, we demonstrated that in the absence of FOXK1, cardiac differentiation was markedly impaired by assaying for cardiac Troponin T expression and cardiac contractility. We demonstrate that FOXK1 is an important regulator of cardiogenesis by repressing the Wnt/β-catenin signalling pathway and thereby promoting differentiation. Conclusion These results identify FOXK1 as an essential transcriptional and epigenetic regulator of cardiovascular development. Mechanistically, FOXK1 represses Wnt signalling to promote the development of cardiac progenitor cells.
Air Pollution and Acute Kidney Injury in the U.S. Medicare Population: A Longitudinal Cohort Study
Authors: Whanhee Lee, Xiao Wu, Seulkee Heo, Joyce Mary Kim, Kelvin C. Fong, Ji-Young Son, Matthew Benjamin Sabath, Ana Trisovic, Danielle Braun, Jae Yoon Park, Yong Chul Kim, Jung Pyo Lee, Joel Schwartz, Ho Kim, Francesca Dominici, Ziyad Al-Aly, Michelle L. Bell
Journal: Environmental Health Perspectives (2023)

Background: Recent studies have reported the association between air pollution exposure and reduced kidney function. However, it is unclear whether air pollution is associated with an increased risk of acute kidney injury (AKI). Objectives: To address this gap in knowledge, we investigated the effect estimates of long-term exposures to fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)], nitrogen dioxide (NO2), and ozone (O3) on the risk of first hospital admission for AKI using nationwide Medicare data. Methods: This nationwide population-based longitudinal cohort study included 61,300,754 beneficiaries enrolled in Medicare Part A fee-for-service (FFS) who were ≥65 years of age and resided in the continental United States from the years 2000 through 2016. We applied Cox-equivalent Poisson models to estimate the association between air pollution and first hospital admission for AKI. Results: Exposure to PM2.5, NO2, and O3 was associated with increased risk for first hospital admission for AKI, with hazard ratios (HRs) of 1.17 (95% CI: 1.16, 1.19) for a 5-μg/m3 increase in PM2.5, 1.12 (95% CI: 1.11, 1.13) for a 10-ppb increase in NO2, and 1.03 (95% CI: 1.02, 1.04) for a 10-ppb increase in summer-period O3 (June to September). The associations persisted at annual exposures lower than the current National Ambient Air Quality Standard. Discussion: This study found an association between exposures to air pollution and the risk of the first hospital admission with AKI, and this association persisted even at low concentrations of air pollution. Our findings provide beneficial implications for public health policies and air pollution guidelines to alleviate health care expenditures and the disease burden attributable to AKI. https://doi.org/10.1289/EHP10729
PD-L1 blockade in combination with carboplatin as immune induction in metastatic lobular breast cancer: the GELATO trial
Authors: Leonie Voorwerk, Olga I. Isaeva, Hugo M. Horlings, Sara Balduzzi, Maksim Chelushkin, Noor A. M. Bakker, Elisa Champanhet, Hannah Garner, Karolina Sikorska, Claudette E. Loo, Inge Kemper, Ingrid A. M. Mandjes, Michiel de Maaker, Jasper J. L. van Geel, Jorianne Boers, Maaike de Boer, Roberto Salgado, Marloes G. J. van Dongen, Gabe S. Sonke, Karin E. de Visser, Ton N. Schumacher, Christian U. Blank, Lodewyk F. A. Wessels, Agnes Jager, Vivianne C. G. Tjan-Heijnen, Carolien P. Schröder, Sabine C. Linn, Marleen Kok
Journal: Nature Cancer (2023)

Abstract Invasive lobular breast cancer (ILC) is the second most common histological breast cancer subtype, but ILC-specific trials are lacking. Translational research revealed an immune-related ILC subset, and in mouse ILC models, synergy between immune checkpoint blockade and platinum was observed. In the phase II GELATO trial ( NCT03147040 ), patients with metastatic ILC were treated with weekly carboplatin (area under the curve 1.5 mg ml –1 min –1 ) as immune induction for 12 weeks and atezolizumab (PD-L1 blockade; triweekly) from the third week until progression. Four of 23 evaluable patients had a partial response (17%), and 2 had stable disease, resulting in a clinical benefit rate of 26%. From these six patients, four had triple-negative ILC (TN-ILC). We observed higher CD8 + T cell infiltration, immune checkpoint expression and exhausted T cells after treatment. With this GELATO trial, we show that ILC-specific clinical trials are feasible and demonstrate promising antitumor activity of atezolizumab with carboplatin, particularly for TN-ILC, and provide insights for the design of highly needed ILC-specific trials.
A battery-less wireless implant for the continuous monitoring of vascular pressure, flow rate and temperature
Authors: Kyeongha Kwon, Jong Uk Kim, Sang Min Won, Jianzhong Zhao, Raudel Avila, Heling Wang, Keum San Chun, Hokyung Jang, Kun Hyuck Lee, Jae-Hwan Kim, Seonggwang Yoo, Youn J. Kang, Joohee Kim, Jaeman Lim, Yoonseok Park, Wei Lu, Tae-il Kim, Anthony Banks, Yonggang Huang, John A. Rogers
Journal: Nature Biomedical Engineering (2023)
Optimization of Cas9 activity through the addition of cytosine extensions to single-guide RNAs
Authors: Masaki Kawamata, Hiroshi I. Suzuki, Ryota Kimura, Atsushi Suzuki
Journal: Nature Biomedical Engineering (2023)

Abstract The precise regulation of the activity of Cas9 is crucial for safe and efficient editing. Here we show that the genome-editing activity of Cas9 can be constrained by the addition of cytosine stretches to the 5′-end of conventional single-guide RNAs (sgRNAs). Such a ‘safeguard sgRNA’ strategy, which is compatible with Cas12a and with systems for gene activation and interference via CRISPR (clustered regularly interspaced short palindromic repeats), leads to the length-dependent inhibition of the formation of functional Cas9 complexes. Short cytosine extensions reduced p53 activation and cytotoxicity in human pluripotent stem cells, and enhanced homology-directed repair while maintaining bi-allelic editing. Longer extensions further decreased on-target activity yet improved the specificity and precision of mono-allelic editing. By monitoring indels through a fluorescence-based allele-specific system and computational simulations, we identified optimal windows of Cas9 activity for a number of genome-editing applications, including bi-allelic and mono-allelic editing, and the generation and correction of disease-associated single-nucleotide substitutions via homology-directed repair. The safeguard-sgRNA strategy may improve the safety and applicability of genome editing.
Isolation of tumour-reactive lymphocytes from peripheral blood via microfluidic immunomagnetic cell sorting
Authors: Zongjie Wang, Sharif Ahmed, Mahmoud Labib, Hansen Wang, Licun Wu, Fatemeh Bavaghar-Zaeimi, Nastaran Shokri, Soraly Blanco, Saraf Karim, Kasia Czarnecka-Kujawa, Edward H. Sargent, A. J. Robert McGray, Marc de Perrot, Shana O. Kelley
Journal: Nature Biomedical Engineering (2023)
Impact of Age and Sex on Left Ventricular Remodeling in Patients With Aortic Regurgitation
Authors: Emmanuel Akintoye, Yoshihito Saijo, Lorenzo Braghieri, Osamah Badwan, Hardik Patel, M Marwan Dabbagh, Joseph El Dahdah, Christine L. Jellis, Milind Y. Desai, L. Leonardo Rodriguez, Richard A. Grimm, Brian P. Griffin, Zoran B. Popović
Journal: Journal of the American College of Cardiology (2023)
Abstract 9219: Community-Level Cardiovascular Risk Factors Impact Geographic Variation in Cardiovascular Disease Hospitalizations for Women
Authors: Fatima Rodriguez, Caitlin E Johnson, Yun Wang, JoAnne M Foody
Journal: Circulation (2011)

Background: Prior work has shown significant geographic variation in cardiovascular (CV) risk factors including metabolic syndrome, obesity, and hypercholesterolemia. However, little is known about how variations in CV risk impact CVD-related hospitalizations. Methods: Community-level CV risk factors (hypertension, dyslipidemia, hyperglycemia, and elevated waist circumference) were assessed from community-wide health screenings sponsored by Sister to Sister (STS) from Jan 2008-Jan 2009 in 17 major US cities. Using data from the Healthcare Cost and Utilization Project (HCUP), CVD hospitalizations were identified based on ICD9 codes for myocardial infarction (AMI), congestive heart failure (CHF), and other CVD discharges. We linked STS data with HCUP hospitalizations based on common cities and restricted the analysis to women discharged from hospitals inside the 17 STS cities. Using hierarchical models with city as a random intercept, we assessed the impact of city-specific CV risk factors on between-city variance of AMI, CHF, and other CVD hospitalization rates. Analyses were also adjusted for patient age and clinical comorbidities. Results: Our analysis yielded a total of 742,445 all-cause discharges across 70 hospitals inside of 13 linked cities. The mean age of women was 51.8 (SD 21.7) with a range of 15 to 101. The overall (city-specific range) proportion of AMI, CHF, and other CVD hospitalizations were 1.03% (0.75 to 1.49%), 2.32% (1.64 to 3.94%), and 2.85% (1.66% to 4.72%), respectively. After adjusting for city-specific CV risk factors, between-city variation was no longer statistically significant for all targeted conditions (Table). Conclusion: We demonstrated that geographic variations in AMI, CHF, and other CVD hospitalizations can be partially explained by community-level CV risk factors. This finding suggests that interventions to reduce CVD should be tailored to the unique risk profile and needs of high-risk communities.
Tuberculosis and HIV Infection in Sub-Saharan Africa
Authors: Kevin M. De Cock
Journal: JAMA (1992)

<h3>Objectives.</h3> —To review the epidemiologic, clinical, and pathological characteristics and the public health implications of human immunodeficiency virus (HIV)— associated tuberculosis in sub-Saharan Africa. <h3>Data Sources.</h3> —Published medical literature (English and French) and proceedings of international and African conferences on the acquired immunodeficiency syndrome (AIDS). <h3>Study Selection.</h3> —Selection by the authors of articles most pertinent to HIV infection and tuberculosis in Africa and internationally. <h3>Data Extraction.</h3> —Direct reporting of quantitative data (eg, HIV seroprevalence levels) and of qualitative descriptions and conclusions from selected literature. <h3>Data Synthesis.</h3> —High rates (20% to 67%) of HIV infection in patients with tuberculosis have been reported from East, West, Central, and Southern Africa. An increase in tuberculosis cases has been reported at the same time as the emergence of AIDS in several countries. Autopsies in Abidjan, Ivory Coast (Côte d'Ivoire), have shown tuberculosis as the most frequent opportunistic infection in patients dying of AIDS. Clinical differences in patients with tuberculosis who were HIV-positive and HIV-negative are reviewed, the most important being a greatly increased mortality rate in HIV-associated disease. Access to HIV testing is required for firm diagnosis, for clinical care and counseling, and for public health surveillance. <h3>Conclusions.</h3> —The epidemiology of tuberculosis has been profoundly influenced by the epidemic of HIV infection in sub-Saharan Africa. Greatly increased human and material resources are required for this neglected problem in international health. (<i>JAMA</i>. 1992;268:1581-1587)